目的:探讨补虚生肌法对促进痔瘘术后创面愈合程度、抗炎作用及疼痛介质的影响。方法:选择符合标准的病例200例,按随机数字表法分为治疗组与对照组各100例。两组患者均采取手术治疗,对照组术后给予康复新液纱条外敷,治疗组在此基础上给予内补黄芪汤优化方颗粒剂。比较两组治疗后创面愈合程度、炎症因子及疼痛介质等相关指标。结果:治疗组总有效率和整体疗效均优于对照组,差异有统计学意义(P<0.05)。术后3、7、14 d创面愈合率和创面愈合时间治疗组与对照组比较差异有统计学意义(P<0.05)。两组术后3、7、14 d疼痛视觉模拟评分法(VAS)评分较术后1 d均有明显降低,且治疗组各时间段VAS评分均低于对照组,差异均有统计学意义(P<0.05)。术后1 d两组血清白细胞介素-1β(IL-1β)、白细胞介素-12(IL-12)和干扰素-γ(IFN-γ)水平比较差异有统计学意义(P>0.05);术后14 d两组血清IL-1β、IL-12、IFN-γ均明显降低,且治疗组明显低于对照组,差异均有统计学意义(P<0.05)。术后1 d两组血清5-羟色胺(5-HT)、前列腺素E2(PGE2)、血清P物质(SP)、神经肽Y(NPY)水平比较,差异无统计学意义(P>0.05);术后14 d两组血清5-HT、PGE2、SP、NPY均低于本组治疗前,且治疗组低于对照组,差异均有统计学意义(P<0.05)。术后1 d两组创面渗透液皮生长因子(EGF)、成纤维细胞生长因子-1(FGF-1)、分泌型IgA(sIgA)、基质金属蛋白酶组织抑制剂-1(TIMP-1)水平比较,差异无统计学意义(P>0.05);术后14 d两组创面渗透液EGF、FGF-1、sIgA、TIMP-1均有明显提高,且治疗组高于对照组,差异均有统计学意义(P<0.05)。结论:补虚生肌法可改善痔瘘术后患者炎症因子和疼痛介质水平,缩短创面愈合进程,减轻患者痛苦,有效弥补西医、单一方法的弊端,提高治疗效果。

Objective:To explore the effect of tonifying deficiency and generating muscle on wound healing,anti-inflammation and pain mediators in postoperative hemorrhoid and fistula. Methods:Two hundred patients that meet the criteria were divided into treatment group and control group using a random number table,100 patients in each group. All patients underwent surgery. Patients after surgery in the control group were treated with external application of Kangfuxin liquid gauze and covered with medical dressing for fixation. Patients in the treatment group were given the Neibu Huangqi Youhua Formula（内补黄芪汤优化方 ） granules besides the treatment in the control group. The degree of wound healing,inflammatory factors and pain mediators were compared between two groups. Results:In the treatment group there were better total effective rate than those in the control group,with statistical difference(P<0.05). On the 3 rd,7 th and 14 th day after operation,there were significant differences between the treatment group and control group on the wound healing rate and the wound healing time(P<0.05). The visual analogue scale(VAS) scores of both groups on the 3 rd,7 th and 14 th day after operation were significantly lower than those on the 1 st day after operation,with statistical difference(P<0.05),and at each time point after operation the VAS scores of the treatment group were lower than these of the control group,with statistical difference(P<0.05). Levels of interleukin(IL)-1β,IL-12 and interferon(IFN)-γ showed no difference between both groups on the 1 st day after operation(P>0.05),and on the14 th day after operation,they became significantly lower in both groups,and in the treatment group were significantly lower than those in the control group(P<0.05). Levels of serum 5-hydroxytryptamine(HT),prostaglandin E2(PGE2),substance P(SP) and neuropeptide Y(NPY) showed no difference between both groups(P>0.05),but they became lower in both two groups on the 14 th day after operation than before operation,and they were lower in the treatment group than in the control group,both with statistical difference(P<0.05). Levels of epidermal growth factor(EGF),fibroblast growth factor(FGF)-1,secretory immunoglobulin A(sIgA) and tissue inhibitor of metalloproteinase(TIMP)-1 showed no statistical difference on the 1 st day after operation(P>0.05),but they became higher on the 14 th day after operation,and were higher in the treatment group than in the control group,both with statistical difference(P<0.05). Conclusions:Tonifying deficiency and generating muscle could improve the level of inflammatory factors and pain mediators,shorten the process of wound healing,relieving suffering of patients,effectively make up for the disadvantages of simple method of western medicine,and therefore improve the treatment effect.